People with diabetes who have difficulty managing their blood glucose levels may experience symptoms such as thirst, frequent urination, fruity breath, and increase in infections.

A diagnosis of type 1 diabetes usually happens in childhood. In this type, the immune system attacks insulin-producing cells in the pancreas, which can no longer produce insulin. The symptoms often appear suddenly.

Type 2 diabetes is more common after the age of 45 years, and symptoms appear gradually. Many people do not know they have type 2 diabetes and so they do not take measures to manage it. In type 2 diabetes, the body cannot use insulin properly. In time, it may stop producing insulin.

Diabetes can impact a person’s quality of life, and if blood glucose levels remain high, it can also be life threatening. A person who recognizes the signs and symptoms can get an early diagnosis and take action to prevent complications from arising.

The following are 10 signs that a person needs help with their treatment for diabetes. Anyone experiencing them should consult a doctor promptly.

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There are different reasons why someone’s diabetes might be uncontrolled. Sometimes, people who use insulin and follow all doctor guidelines will still have blood sugar levels that are too high. In these cases, a doctor will need to adjust their treatment or prescribe other medications.

In addition, approximately 37.3 million adults in the United States had diabetes in 2019, according to statistics from the Centers for Disease Control and Prevention (CDC). Of these, at least 8.5 million did not have a diagnosis.

And according to an older 2011 study, there may be at least 2.4% of people who have a diagnosis but are not receiving treatment. This may result from experiencing poor mental health, not having a family support system, or belonging to historically marginalized groups that experience inequities in access to healthcare.

High blood glucose readings are the most obvious sign that diabetes needs attention.

When a person works out their treatment plan with their doctor, the doctor will advise them on their target glucose levels. These can vary between people.

The CDC note that healthy blood sugar levels are usually 80–130 milligrams per deciliter (mg/dL) before meals and under 180 mg/dL two hours after eating.

The correct use of diabetes medication and lifestyle changes can usually bring blood glucose within target ranges.

If blood glucose remains too high or is steadily rising, the person should speak with their doctor as they may need to adjust their treatment plan.

High blood sugar levels can increase a person’s susceptibility to infections. A person should see a doctor if they start to have more frequent infections or if they take longer to recover from a wound or infection than they did before.

People with diabetes are more likely to develop conditions such as:

Yeast feeds on sugar, so the combination of lowered immunity and high blood glucose makes people with diabetes particularly at risk of frequent yeast infections.

Infections that occur with diabetes also take longer to heal and can worsen more quickly than in other people. Without prompt treatment, sepsis, a life threatening complication, can develop.

Diabetic foot ulcers, for example, can lead to tissue death and possibly the need for amputation.

People should check regularly for skin changes and seek medical help as soon as they have any signs of an infection.

Learn more here about why people with diabetes should take extra care with their feet.

Frequent urination, or polyuria, is a common sign of uncontrolled type 1 and type 2 diabetes.

Usually, people release about 1–3 quarts of urine daily. In cases of untreated diabetes, a person may release as much as 20 quarts of urine a day.

This happens due to hyperglycemia when the body tries to rid the blood of excess glucose. When sugar levels are high, people also drink more frequently, causing them to produce more urine.

What does it mean if you are urinating more than usual? Click here to find out more.

People with diabetes sometimes experience polydipsia, an extreme form of thirst.

This is common in uncontrolled type 1 diabetes and can also occur with type 2 when blood sugar levels are very high.

High blood glucose can result in dehydration and thirst, and it can reduce the body’s ability to absorb water.

A person may experience:

  • an overwhelming need for water
  • a chronically dry mouth
  • dizziness

Both excessive thirst and excessive urination are more likely to occur when a person’s blood glucose levels are above 250 mg/dL.

Since the two conditions can happen together, dehydration may occur even when a person drinks more fluids.

Diabetic ketoacidosis

Dehydration results from diabetic ketoacidosis (DKA), a life threatening emergency that can arise when the body cannot access glucose for energy and starts to break down fat instead.

Ketones are a byproduct of this process. As they accumulate in the blood, they can make it too acidic.

Symptoms of DKA include:

  • dizziness
  • nausea and vomiting
  • confusion
  • abdominal pain
  • fruity-smelling breath
  • a loss of consciousness and possibly a diabetic coma

People with diabetes who experience symptoms of DKA need immediate medical attention. DKA can be fatal, and it needs emergency hospital treatment.

A person with diabetes may have high blood glucose levels, but their cells cannot access this glucose to use as energy.

This happens because the body either does not produce insulin or cannot use insulin correctly.

Insulin is necessary for processing glucose effectively. Even if a person has high blood sugar levels, their body may lack energy.

This can lead to polyphagia, in which the body triggers hunger signs as it tries to gain access to fuel. Even when a person eats, hunger may persist as the body continues to ask for fuel.

Although there is a link between obesity and type 2 diabetes, people who have difficulty managing their diabetes may not gain weight, even when they overeat.

If a person has a big appetite but does not gain weight, this suggests their body is not getting all the energy it needs from food.

This inability to absorb glucose can also lead to weight loss.

Whether a person with diabetes loses weight depends on how well the body uses glucose and how much that person eats. It may also be related to excessive urination that can occur with diabetes.

If a person appears to be overeating but still loses weight, they should see a doctor.

People with high blood sugar levels may notice that their breath smells fruity or sweet.

When the body cannot access glucose from the blood due to insulin problems, it breaks down fat for energy. This creates a chemical called acetone that can have a fruity smell.

A “fruity” breath can also be a sign of DKA, a potentially life threatening condition that can develop over a few hours. Anyone who has this symptom should seek medical help at once.

Learn more here about what causes acetone breath and when to see a doctor.

Over time, high glucose levels can damage the blood vessels, including those of the kidneys.

As the kidneys work harder to filter the blood, kidney disease can result. About 1 out of 3 adults with a diagnosis of diabetes also have kidney disease.

People with both diabetes and kidney disease may notice:

  • very dark or bloody urine
  • frothy urine
  • pain near the kidneys in the lower back
  • chronic kidney or urinary tract infections

Kidney disease produces few or no symptoms in its early form. When symptoms appear, there may already be damage.

This is one reason why it is important to know if diabetes is present and manage blood sugar levels as soon as possible.

How does diabetes affect the kidneys? Click here to learn more.

People with diabetes often have cardiovascular symptoms, such as high blood pressure. They may also have high cholesterol levels and obesity, which are risk factors for heart disease.

Of all the complications of diabetes, cardiovascular disease is the one that is most likely to be fatal, according to research.

Poor circulation can also contribute to slow wound healing and problems in the extremities, such as the feet.

High blood pressure, chest pain, or abnormal heart rhythms are important warning signs. People should not ignore them, whether they are due to diabetes or another condition.

How does diabetes increase the risk of stroke? Find out more here.

Long-term high blood sugar levels can damage nerves throughout the body, particularly those that affect sensation in the hands or feet. If a person has numbness or tingling, they may have nerve damage or diabetic neuropathy.

Some people with diabetes experience nerve pain, which can feel like electrical sensations or burning. Nerve pain can happen anywhere, but it is especially common in the feet and hands.

People who experience these symptoms should contact a doctor. Redness, swelling, or warmth in the legs can indicate a medical urgency that needs immediate attention in an emergency room.

What is diabetic neuropathy, and how does it affect a person? Click here to learn more.

Anyone who experiences any of the above symptoms should see a doctor as soon as they can, whether or not they have a diabetes diagnosis, as they may have diabetes without knowing it.

The sooner a person starts to manage high blood sugar, the better chance they have of slowing its progress and reducing the risk of complications.

Anyone with DKA or chest pain symptoms should seek emergency medical attention without delay.

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